Right now you’re taking a lot of medicines to treat your kidney disease. When you have a kidney transplant, the type of medicine will change.

Your body won’t want to welcome your new kidney. Your immune system will do its best to fight against it, because it sees the kidney as a stranger to your body. To stop your body from rejecting the transplanted kidney, you must take a lot of medicines. These are called immunosuppressive medicines or anti-rejection medicines. You will start taking these medicines before surgery and need to keep taking them after surgery. Right after surgery you will take them through an intravenous (IV) line.

You will also get medicine to help you manage pain after the surgery. A nurse may give you pain medicine that you take by mouth or through an IV. Some patients may have a patient-controlled analgesia (PCA) pump so you can give yourself pain medicine through your IV as soon as you need it.

For the transplant to be successful, you must take immunosuppressive medicines every day, for as long as you have your transplanted kidney. You’ll also take other medicines for a short time. If you were taking blood pressure pills before your surgery, you’ll likely need to keep taking them.

Patients who have a weakened immune system because they take immunosuppressive medicines are called immunocompromised. They will need to be watched more closely. If you are immunocompromised, it will be harder for body to fight off an infection and destroy abnormal cells. This can increase your risk for some types of infections and cancers. You will get medicines to help prevent some types of infection. You need to take these medicines for at least 3 months after the transplant and in some cases for the rest of your life.

Taking so many medicines every day can be hard. But it’s very important. Missing doses could cause your body to reject the new kidney.

Never stop taking your medicines.

What are the side effects of immunosuppressive medicines?

These medicines have many different side effects. You and your post-transplant team may spend the first few years after transplant managing these side effects. Talk to your team if you have any questions or concerns.

As your kidney starts to work normally, medicine doses and their side effects will become less. The most common side effects that won’t last long include diarrhea, nausea and vomiting, and hand tremors. Serious side effects could include infections, diabetes, and cancer.

The transplant team will talk to you about your risk of medicine side effects. It’s hard to predict what side effects a person may have after a transplant. You know your body best. Tell your transplant team if notice any side effects so they can help you manage these side effects.

Some possible side effects of kidney transplant medicines include:

• nausea, diarrhea, heartburn, or vomiting
• abnormal levels of electrolytes (such as potassium and magnesium) in the blood
• high blood pressure
• changes in the levels of your blood cells
• increased appetite and weight gain
• shaking you can’t control (called tremors) or tingling in the hands or feet
• mood changes, night sweats, dreams that seem real (called vivid dreams), sleep problems, and anxiety
• headaches
• rounding of the face (called “moon face”)
• bone weakness or osteoporosis
• having more or less hair growth
• higher blood sugar levels
• higher risk of infections and cancer

What can I do to help me remember to take my medicines?

You will have many changes to your medicines in the first few months after your transplant. It’s important to be organized and remember to take your medicines and take them when you’re supposed to. This can be challenging for some patients.

The following tips can help you remember to take your medicines:

• Set an alarm on your phone.
• Ask your pharmacy to package your medicines together in blister packs.
• Put your medicines on a table by your bed.
• Take your medicines at the same time as other activities that are part of your daily routine, such as eating breakfast or brushing your teeth.
• Put a reminder note or sign in a place where you will see it.
• Ask someone to remind you to take your medicines.

What else do I need to know?

If you have problems with your medicines, the transplant team will help you to deal with them. Don’t stop taking your medicines. If you stop taking your immunosuppressive medicines, your body will start to reject your new kidney and you will put yourself at risk for other health problems. If your body is rejecting your new kidney, you will need treatment as you risk losing your kidney. Losing your kidney in this way might make it harder to find a matched kidney in the future, because your body will have made more antibodies to attack any new kidney. It may also lower your chance of getting another kidney transplant or make you unable to have another kidney transplant. For these reasons, don’t stop or change the way you take your medicines without talking to the transplant team first.

Many other medicines can interact with your immunosuppressive medicines. Talk to the transplant team before you start any new medicines including over-the-counter medicines such as ibuprofen, naproxen, or regular dose aspirin (the small dose of aspirin to prevent a heart-related event is okay to take), supplements, and herbal medicines.

Always carry an up-to-date list of your medicines with you. You can ask for an updated list each time you visit the clinic.

You may also wonder how alcohol, cannabis, or illegal drugs interact with your medicines. Don’t drink alcohol in the first few weeks after your transplant. Having a drink once in a while is fine for most people, but check with the transplant team first. Talk to the transplant team before using cannabis. Don’t use illegal drugs.